自体造血干细胞移植治疗恶性淋巴瘤应用进展–.Indications for Hematopoietic Stem Cell Transplants in the United States, 2010(Inflation factor: Auto=1.25 (80%), Allo=1.05 (95%), All Transplants)SUM12_28.pptSlide 8Number of Transplants05001,0001,5002,0002,5003,0003,5004,0004,5005,0005,500MultipleMyelomaNHLAMLALLMDS/MPDHDCMLAplasticAnemiaOtherLeukNon-MaligDiseaseOtherCancerAllogeneic (Total N=8,860)Autogeneic (Total N=9,026)–.1. HL, 霍奇金淋巴瘤–.HL :ASCT 综合治疗效果• 复发/ 耐药 ： • CR 34-80 % • 长期生存率： 25- 50%• 早期死亡率 ：4 －21 ％• 复发/ 耐药 ：• 10 年生存率：50% • 10y PFS ： 45% • 10y RFS ： 23%• 首次复发：• 5 年PFS 30 –52%, • 5 年生存率： 34 －60 ％ –.复发难治HL PET/CT 结果与自体移植的疗效关系–Haematologica 2012 PET/CT - PET/CT + –.复发难治HD : 不同预处理方案比较–.•1998-2009•100 pts•BuMelTt(busulfan, melphalan,thiotepa): 60pts•Others:40pts–CBV(21)–TBICyE(14)–BEAM(4)–Melphalan(1)•5 yr-OS 73% VS. 44%•5 yr-PFS 66% VS. 37%•No differences in toxicity and NRMImproved outcome with busulfan, melphalan and thiotepa conditioning in AHSCT for –relapsed/refractory HLTarunpreet B. Leukemia & Lymphoma, 2014; 55(3): 583–587PFSOSP=0.03P=0.05–.2. NHL, DLBCL 弥漫大B 淋巴瘤–.复发NHL: 自体移植是标准治疗手段 PARMA 随机对照研究–OS–PFS–.美罗华治疗后复发：AHSCT 价值，> 2nd–.Rituximab + DHAP and ASCT 复发DLBCL–Edo Vellenga et al, blood,2008 111: 537-543–DHAP112 73 40 19 9–R-DHAP 113 76 55 31 14–R-DHAP–DHAP– Cumulative percentage– Overall survival–.CORAL 研究： 移植后疗效 EFS–Failure from diagnosis =>= 12 months–Failure from diagnosis > 12 months–Failure from diagnosis =< 12 months–Standard salvage regimen does not overcome poor prognosis of early relapse–. Rituximab- 化疗复发：自体移植的疗效 •Br J Haematol. 2014 Mar;164(5):668-74•.• 有研究提示，美...
